APPLICATION FORM FOR ISSUE OF TRADING LICENSE ANNEXURE-I Full Name of the Applicant1. Age2. 3. Permanent Address4. Village PO & PS District Present Address5. 6. Land allotment order No. & Date Attested photocopy to attached Location of plot7. Sector Type of Building8. OBIT/ MIBT/ SPT/ Log Type .RCC/ Total Plinth area of Building9. Total covered area of fencing 10. 11. Whether space for parking and storage provided Yes No Details of shop Rooms :12. 13. Whether land revenue paid upto date (photocopy of Try-Challan be Yes No many Trade would be carried out in each of them. Published on National Portal of India (india.gov.in) Father's/ Husband's Name Yet to be constructed compound wall Indicated on annexure-II (specify how many shop rooms are there and how attached land sketch map photocopy). In case of rented premise, submit following details14. Lease agreement in original to be attached Name of owner of building with document land allotment and electricity bill. Permanent address of owner Village Circle District 15. In case of partnership business furnished The following details, a. b. Deed of partnership List of share holders as provided in the guidance (indicated on Annexure - III) Yes No Yes No 16. In case of Pvt. Ltd Company business a. b. Registration Certificate Memorandum of Articles of Association. List of share holders as provide in the guidelines (indicated on Annexure - III) (Includes all partners in case of partnership and share holder in case of companies) Yes No 17. Have you ever been convicted by any 18. Total investment amount within Rupees Yes No Yes No Published on National Portal of India (india.gov.in) Yes No furnished.The following details, court of law for committing unlawful activities.If yes, give details office for Government Approval) Ten lakhs, (if not, forwarded by DC/ADC a. b. c. c. UNDERTAKING /VERIFICATION I/We do hereby solemnly affirm that the information above is true and correct to the best of my/our knowledge and belief. I/We do hereby undertake to abide by all the terms and condition of trading license if issued to me/us and also undertake the same in case expiry of lease agreement without further extension of the lease. Signature in full of the Applicant Place: Date: ANNEXURE-II (See SL.NO.12 of the format) SL. No. Room No. Name and Style of Business Articles to be traded service to be rendered 1 2 3 4 1. 2. 3. 4. 5. 6. Published on National Portal of India (india.gov.in) It also certify that, I am not (do not) belongs to family of a government employees. Full name and signature of the applicant Verification report/comments of authorized officer/official Name and Signature of Inspector/authorized official 11. 7. 8. 9. 10. 12. Published on National Portal of India (india.gov.in) run in that particular location Specify (with reason) why these activities can be (Residential/Commercial) ANNEXURE-III Full name and address of share holder No. of share Total 1 2 3 4 1. 2. 3. 4. 5. 6. 7. Published on National Portal of India (india.gov.in) SL No. 8. (See Sl No. 15 & 16 of the Format) 12. 9. 10. 11. 13. Full Name and Signature of the applicant Initial of authorized Official/Inspector Published on National Portal of India (india.gov.in) 15. 14. 16.
